The cost effectiveness of transcatheter aortic valve implantation (TAVR) compared to surgical aortic valve replacement (SAVR) depends on whether TAVR is performed via the femoral artery or transapically, through a small incision in the chest, according to a new study.

Recently, transcatheter aortic valve implantation (TAVR) has been shown to result in similar 12-month survival as surgical aortic valve replacement (SAVR) for high-risk patients with severe aortic stenosis. The potential cost-effectiveness of TAVR versus SAVR in the PARTNER trial was examined and the results were presented today at the 23rd annual Transcatheter Cardiovascular Therapeutics (TCT) scientific symposium, sponsored by the Cardiovascular Research Foundation.

The PARTNER trial randomized patients with severe, symptomatic aortic stenosis and high surgical risk to either TAVR (N=348) or SAVR (N=351) and followed them for a minimum of 12 months. Health state utilities were estimated using the EuroQOL (EQ-5D) at baseline, one, six, and 12 months. Detailed medical resource utilization data were collected on all study patients, and hospital billing data were collected for both index and follow-up hospitalizations for any cause from consenting U.S. patients.

The objectives of the study were to combine cost data with survival and Quality of Life (QoL) data to estimate the12-month cost-effectiveness of TAVR compared with AVR and to explore potential differences in costs and cost-effectiveness of TAVR vs. AVR for the transfemoral vs. transapical populations.

Among high risk aortic stenosis patients eligible for the transfemoral approach, TAVR, compared with surgical AVR:

Provided small but significant gains in 12 month quality-adjusted life expectancy (0.06 – 0.07 Quality Adjusted Life Years, QALYs)

Was associated with higher procedural costs but slightly lower index hospitalization and total 12 month costs

However, not all patients qualify medically for the transfemoral approach. Among patients only eligible for the transapical approach:

"Results of this trial indicate that for patients with severe aortic stenosis and high surgical risk, transcatheter aortic valve replacement is an economically attractive and possibly dominant strategy compared with surgical aortic valve replacement, provided that patients are suitable for the transfemoral approach," said Matthew R. Reynolds, MD. Dr. Reynolds is Director of the Economics and Quality of Life Research Center at Harvard Clinical Research Institute (HCRI), an Assistant Professor of Medicine at Harvard Medical School and Associate Director of Electrophysiology at the Boston VA Health Care System.

"Whether the transapical approach can be refined to provide faster recovery and better results from a cost perspective should be the subject of further study."

The PARTNER trial is funded by a research grant from Edwards Lifesciences, Inc. Dr. Reynolds reported that his research organization (HCRI) receives research grant support from the company.

About CRF and TCT

The Cardiovascular Research Foundation (CRF) is an independent, academically focused nonprofit organization dedicated to improving the survival and quality of life for people with cardiovascular disease through research and education. Since its inception in 1991, CRF has played a major role in realizing dramatic improvements in the lives of countless numbers of patients by establishing the safe use of new technologies, drugs and therapies in interventional cardiovascular medicine.

Transcatheter Cardiovascular Therapeutics (TCT) is the annual scientific symposium of the Cardiovascular Research Foundation. TCT gathers leading medical researchers and clinicians from around the world to present and discuss the latest developments in the field.

Die letzten 5 Focus-News des innovations-reports im Überblick:

Nano- and microtechnology are promising candidates not only for medical applications such as drug delivery but also for the creation of little robots or flexible integrated sensors. Scientists from the Max Planck Institute for Polymer Research (MPI-P) have created magnetic microparticles, with a newly developed method, that could pave the way for building micro-motors or guiding drugs in the human body to a target, like a tumor. The preparation of such structures as well as their remote-control can be regulated using magnetic fields and therefore can find application in an array of domains.

The magnetic properties of a material control how this material responds to the presence of a magnetic field. Iron oxide is the main component of rust but also...

Due to the special arrangement of its molecules, a new coating made of corn starch is able to repair small scratches by itself through heat: The cross-linking via ring-shaped molecules makes the material mobile, so that it compensates for the scratches and these disappear again.

Superficial micro-scratches on the car body or on other high-gloss surfaces are harmless, but annoying. Especially in the luxury segment such surfaces are...

The Potsdam Echelle Polarimetric and Spectroscopic Instrument (PEPSI) at the Large Binocular Telescope (LBT) in Arizona released its first image of the surface magnetic field of another star. In a paper in the European journal Astronomy & Astrophysics, the PEPSI team presents a Zeeman- Doppler-Image of the surface of the magnetically active star II Pegasi.

A special technique allows astronomers to resolve the surfaces of faraway stars. Those are otherwise only seen as point sources, even in the largest telescopes...

Researchers at Chalmers University of Technology and the University of Gothenburg, Sweden, have proposed a way to create a completely new source of radiation. Ultra-intense light pulses consist of the motion of a single wave and can be described as a tsunami of light. The strong wave can be used to study interactions between matter and light in a unique way. Their research is now published in the scientific journal Physical Review Letters.

"This source of radiation lets us look at reality through a new angle - it is like twisting a mirror and discovering something completely different," says...